Individual
LAURA BONNEVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NCC
Contact information
Practice address
423 N 3RD AVE STE 210, SANDPOINT, ID 83864-1511
(208) 265-2221
Mailing address
13114 N WESTWOOD DR, HAYDEN, ID 83835-7464
(208) 660-3261
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
LPC-7028
ID
Other
Enumeration date
09/19/2018
Last updated
10/23/2024
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